20 February 2005	Sunday	10 Muharram 1426

KARACHI, Feb 19: Promotion of safe hospital waste management practices still remain a far cry even in Karachi in the absence of a meaningful coordination among different government agencies.

A source privy to the health-care waste management has made a conservative assessment that there are 2500-3000 hospitals, health centres, laboratories, and clinics in the city, which generate 15,000 to 20,000 tonnes of hazardous waste.

In addition, they are also disposing of the liquid hospital waste directly into the municipal sewerage system, which can prove a source of the spread of epidemics. Only 15 to 20 per cent of such waste is disposed of scientifically, while the remaining quantity of medical waste is either handled with municipal solid waste or recycled or reused for financial benefits.

The pathetic situation can be addressed only when individuals, including doctors, government agencies and policy and law makers work with a zeal, leading to healthy and safe environment for people, said a senior physician.

Individuals exposed to hospital waste were potentially at health risk. On the other hand, health-care workers and others in the recycling business are at the risk of acquiring blood-borne pathogens.

Under the Pakistan Environmental Protection Act, 1997, hospital waste falls within the category of hazardous waste and as such institutions responsible for unsafe or improper handling of the waste in question can be tried for legal action, said an environmentalist.

Environmental experts believe that among other protection measures, minimum generation of medical waste, proper recovery of materials and segregation of toxic hospital waste can help a lot to rectify the situation.

In addition to about half a dozen incineration plants owned by the government and private hospitals, the City District Government Karachi has two plants, each with a capacity of incarnating 1,000 kg per hour.

At present, only one of the city government's plants, while operating under 20-25 per cent of its capacity, is incinerating hospital waste collected and transported from about 140 hospitals only, said a city government solid waste manager.

Perturbed due to ignorance or carelessness, the city government had about 10 months back issued notices to different hospitals and health centres, urging them to utilize their incineration facility or face legal action.

In view of the poor response from hospitals, many of them influential, the solid waste management department of the city government also apprised the provincial environmental agency of the situation as well, but any encouraging result is still to be seen, the official added, saying his department is also making efforts to seek services of some magistrates for implementation of environmental laws.

About eight months back, the Sindh Environmental Protection Agency had issued an environmental protection order and guidelines for safe disposal of hospital waste, but no significant improvement could be seen so far.

It is an open secret now that the SEPA lacks infrastructural facilities for the purpose. "We are short of field and technical staff as well as funds, and it is why that despite the pressing needs we are failing to promote sound hospital waste management practices and help other agencies or individuals who are agitated with poor waste management measures, added an official.

However, independent experts felt that the SEAPA should hire a couple of legal experts and field staff so that cases could be registered against polluters and environmental act provisions could be exercised, while on the other hand, it should also coordinate with the district government, as well as under the rules, these are the DCOS and EDOs who can prove more effective in achieving the desired results.

They also stressed the need for sustainable and collaborative approaches towards development of a safe handling of health-care waste. They also called for an official data-base pertaining to hospitals, clinics, maternity homes, laboratories and other health concerns so that those involved in anti-people practices can be brought to book.

Talking about the possibilities of support and cooperation, the secretary of the health department, Prof Naushad Shaikh, said his department was preparing for registration of all clinics and hospitals in the province and as such the institutions, among other things, can also be required to observe rules pertaining to safe disposal of health care waste and use the incinerators compulsorily.